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Urodynamic and questionnaire findings in urinary incontinent women with and without diabetes. Data from a health study

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Introduction and hypothesis

Our aim was to compare urodynamic findings in urinary incontinent (UI) women with and without diabetes.


In the extensive Lolland-Falster Health Study, women with lower urinary tract symptoms were offered urodynamic testing. After excluding 6 women with incomplete urodynamic testing and 88 women without UI, our analysis ended up including 417 women (31 with and 386 without diabetes). Student’s t-test and chi-squared test were used to compare differences of urodynamic findings. Urodynamic testing consisted of a 2-day bladder diary, post-void residual urine volume, filling cystometry, pressure-flow study, cough stress test, and uroflowmetry. Three experienced physicians in urogynecology evaluated all urodynamic findings leading to an overall conclusion of the test results.


Self-reported data showed that compared to incontinent women without diabetes, incontinent women with diabetes had more frequent leakage, a larger amount of leakage, and a higher ICIQ score. A positive ICS Uniform cough stress test was more prevalent in women with diabetes. There were no significant differences in other urodynamic findings or overall conclusion between the two groups. Controlling for age and BMI did not affect our findings.


Women with diabetes complained more about UI, had a higher ICIQ score, and had a positive ICS Uniform cough stress test more often than women without diabetes. Based on these findings, we recommend to include the history of urinary incontinence in the care of women with diabetes. This sample consists of women from a comprehensive health study with different severity of UI. Therefore, it can serve as a reference cohort for future studies.

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Body mass index


Detrusor overactivity


Glycated hemoglobin


International Consultation of Incontinence Questionnaire-Overactive Bladder


International Consultation of Incontinence Questionnaire-Urinary Incontinence Short Form


International Continent Society


Lolland-Falster Health Study


Lower urinary tract symptoms


Mixed urinary incontinence


Voiding detrusor pressure at maximum flow rate


Post-void residual urine volume

SLGT2 inhibitor:

Sodium-glucose cotransporter-2 inhibitor


stress urinary incontinence


Urodynamic stress incontinence


  1. Izci Y, Topsever P, Filiz TM, Çınar ND, Uludağ C, Lagro-Janssen T. The association between diabetes mellitus and urinary incontinence in adult women. Int Urogynecol J Pelvic Floor Dysfunct. 20(8):947–52.

  2. Ebbesen MH, Hannestad YS, Midthjell K, Hunskaar S. Diabetes and urinary incontinence – prevalence data from Norway. Acta Obstet Gynecol Scand. 2007;86:1256–62.

    Article  PubMed  Google Scholar 

  3. Bani-Issa W, Almomani F, Eldeirawi K. Urinary incontinence among adult women with diabetes in Jordan: epidemiology, correlates and perceived impact on emotional and social well-being. J Clin Nurs. 2014;23(17–18):2451–60.

    Article  PubMed  Google Scholar 

  4. Brown J. Lifestyle intervention is associated with lower prevalence of urinary incontinence. Diabetes Care. 2006;29(2):385–90.

    Article  PubMed  Google Scholar 

  5. Phelan S, et al. Long-term prevalence and predictors of urinary incontinence among women in the diabetes prevention program outcomes study. Int J Urol. 2015;22(2):206–12.

    Article  PubMed  Google Scholar 

  6. Weinberg AE, Leppert JT, Elliott CS. Biochemical measures of diabetes are not independent predictors of urinary incontinence in women. J Urol. 2015;194(6):1668–74.

    Article  CAS  PubMed  Google Scholar 

  7. Løwenstein E, et al. Prevalence of urinary incontinence among women with diabetes in the Lolland-Falster health study, Denmark. Neurourol Urodyn Mar. 2021.

  8. Yoshimura N, Chancellor MB, Andersson K-E, Christ GJ. Recent advances in understanding the biology of diabetes-associated bladder complications and novel therapy. BJU Int. 95(6):733–8.

  9. Golabek T, Kiely E, O’Reilly B. Detrusor overactivity in diabetic and non-diabetic patients: is there a difference? Int Braz J Urol. 2012;38(5):652–60.

    Article  PubMed  Google Scholar 

  10. Starer P, Libow L. Cystometric evaluation of bladder dysfunction in elderly diabetic patients. Arch Intern Med. 1990;150(4):810–3.

    Article  CAS  PubMed  Google Scholar 

  11. Changxiao H, et al. Clinical and urodynamic evaluation of women referred with diabetes mellitus. Int Urogynecol J. 2014;25(7):979–83.

    Article  PubMed  Google Scholar 

  12. Pedersen CB. The Danish civil registration System. Scand J Public Health. 2011;39(7_suppl):22–5.

    Article  PubMed  Google Scholar 

  13. Jepsen R, et al. Lolland-Falster health study: study protocol for a household-based prospective cohort study. Scand J Public Health. Jun. 2020;48(4):382–90.

    Article  PubMed  Google Scholar 

  14. Egholm CL, et al. Questionnaire development for the Lolland-Falster Health Study, Denmark: an iterative and incremental process. BMC Med Res Methodol. 2020;20(1):52.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322–30.

    Article  PubMed  Google Scholar 

  16. Clausen J, Gimbel H, Arenholt LTS, Løwenstein E. Validity and reliability of two Danish versions of the ICIQ-UI SF. Int Urogynecol J Mar. 2021.

  17. Rosier PFWM, et al. International continence society good urodynamic practices and terms 2016: urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn. 2017;36(5):1243–60.

    Article  PubMed  Google Scholar 

  18. Jarvis TR, Chan L, Tse V. Practical uroflowmetry. BJU Int. 2012;110(S4):28–9.

    Article  PubMed  Google Scholar 

  19. Colli E, Artibani W, Goka J, Parazzini F, Wein AJ. Are urodynamic tests useful tools for the initial conservative management of non-neurogenic urinary incontinence? A review of the literature. Eur Urol. 2003;43(1):63–9.

    Article  PubMed  Google Scholar 

  20. Pedersen LS, Lose G, Høybye MT, Elsner S, Waldmann A, Rudnicki M. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta Obstet Gynecol Scand. 96(8):939–48.

  21. Kaplan SA, Te Alexis E, Blaivas JG, McGuire EJ. Urodynamic findings in patients with diabetic cystopathy. J Urol. 1995;153(2):342–4.

    Article  CAS  PubMed  Google Scholar 

  22. Chowdhury R, Shah D, Payal AR. Healthy worker effect phenomenon: revisited with emphasis on statistical methods – a review. Indian J Occup Environ Med. 2017;21(1):2–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jepsen R, et al. Socio-economic determinants of participation in the Lolland-Falster health study. J Public Health, vol Open Access. 2019.

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The authors thank the women participating and contributing with valuable data for this study. Another acknowledgment and thanks go to the three specialist nurses for contributing with the assessment of the many urodynamic tests: Jette Fauerholm, Lene Bønnelykke, and Jytte Pedersen, and to the Department of Gynecology and Obstetrics, Nykøbing Falster Hospital, for lending us urodynamic equipment for our test. The Lolland-Falster Health Study (LOFUS), Nykøbing Falster Hospital, Denmark, is a collaboration between Lolland and Guldborgsund Municipalities, Region Zealand, and Nykøbing Falster Hospital. The authors are grateful to LOFUS for collaborating and making the LOFUS research data available. However, LOFUS bears no responsibility for analyses or interpretations conducted within this study.


This study was funded by Nykøbing Falster Hospital; Department of Gynecology and Obstetrics, Nykøbing Falster Hospital; Region Zealand Health Research Fund; Department of Gynecology and Obstetrics, Zealand University Hospital, Roskilde; Production, Research and Innovation, Region Zealand; "Cutting the Edge” prize from Astellas to co-supervisor Lea Laird Andersen; Edith and Henrik Henriksens Memorial Fund; King Christian X's memorial Fund; Grosserer L.F. Foghts Fund; Aase and Ejnar Danielsen Fund; AP Møller Fund.

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Authors and Affiliations



E Løwenstein: Protocol/project development, Data collecting and management, Data analyses, Manuscript writing and editing.

LL Andersen: Project development, Manuscript editing.

J Laigaard: Project development, Data management, Manuscript editing.

LA Møller: Project development, Data management, Manuscript editing.

H Gimbel: Protocol/project development, Data management, Manuscript writing and editing.

Corresponding author

Correspondence to Ea Papsø Løwenstein.

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The authors declare that they have no conflict of interest.

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Løwenstein, E.P., Andersen, L.L., Møller, L.A. et al. Urodynamic and questionnaire findings in urinary incontinent women with and without diabetes. Data from a health study. Int Urogynecol J 32, 2847–2856 (2021).

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